• The Korean Journal of Pain
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• v.31 no.4
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• pp.277-288
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• 2018

Background: Neck and back pain are leading sources of disability placing substantial burden on health care systems. Surgical interventions in managing chronic neck pain secondary to various disorders continue to increase. Even though surgical interventions are effective, a significant proportion of patients continue to have symptomatology and develop cervical post-surgery syndrome. This study was performed to know the effectiveness of cervical interlaminar epidural injections with or without steroids. Methods: The effectiveness of fluoroscopic cervical interlaminar epidural injections in post-surgery syndrome was evaluated in a randomized, active controlled trial. The study population included 116 patients assigned to 2 groups. Group 1 received cervical interlaminar epidural injections with local anesthetic alone and Group 2 received injection with local anesthetic and steroids. The main outcomes were defined as significant improvement (greater than 50%) of pain relief using the numeric rating scale and/or functional status improvement using the Neck Disability Index (NDI). Results: Both groups had similar results with significant improvement (${\geq}50%$ pain relief and functional status improvement) in 69% of the patients in Group I, whereas, in Group II, 71% of the patients showed significant improvement at the end of 2 years. During a 2-year period, the average number of procedures was 5 to 6, with an average of approximately 12 weeks of significant improvement per procedure. Conclusions: Fluoroscopic cervical interlaminar epidural injections administered in cervical post-surgery syndrome using local anesthetic, regardless of the use of steroids, may be effective in approximately 70% of the patients at 2-year follow-up.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.16 no.2
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• pp.79-86
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• 2021

Objectives This study aimed to assess the role of complex Korean medicinal treatment with Chuna manual therapy in two patients with chronic pain after posterior lumbar fusion surgery. Methods A retrospective analysis was performed on 2 patients postoperatively based on their medical records. The surgery regions were verified using T2-weighted axial magnetic resonance imaging. Patients with chronic pain after spondylolisthesis posterior lumbar fusion surgery received complex Korean medicinal treatment with Chuna manual therapy during hospitalization. Numeric rating scale (NRS) in the degree of 0-10 and Oswestry disability index (ODI) were measured before and after treatment. Results Case 1 had an improved NRS score from 7 to 4, and Case 2 had an improved NRS score from 7 to 5. In addition, ODI score improved in both cases. Conclusions Complex Korean medicinal treatment with Chuna manual therapy is effective for relief from chronic pain after posterior lumbar fusion surgery.

• PNF and Movement
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• v.13 no.4
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• pp.197-202
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• 2015

Purpose: This study aimed to examine the effects of a proprioceptive neuromuscular facilitation (PNF) program on neck pain, cervical range of motion, pressure pain, and the cervical flexion-relaxation ratio in a visual display terminal (VDT) worker. Methods: We recruited a 33-year-old VDT worker diagnosed with chronic VDT syndrome. The subject was treated using a PNF program for 20 minutes a day, three times a week for six weeks. All evaluations were performed every two weeks on the first test day. Results: The PNF program resulted in a significant improvement in the subject's neck pain, cervical range of motion, pressure pain, and the cervical flexion-relaxation ratio after six weeks, in comparison to the subject's condition before treatment. Conclusion: The PNF program can be used effectively to improve neck pain, cervical range of motion, pressure pain, and the cervical flexion-relaxation ratio in visual display terminal (VDT) workers.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.4
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• pp.67-75
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• 2016

Objectives The purpose of this study was to investigate the clinical usefulness of M-test (Meridian test) as an adjunctive evaluation and treatment in patients with chronic neck pain. Methods This study was a single arm pre-post comparison study. Thirty-six eligible subjects with chronic neck pain were recruited from August to September, 2015. M-test was used for evaluating the condition of meridian, which can induce the limitation of ROM and body discomfort. Subjects were offered intradermal acupuncture treatment on one-acupoint for 48 hours. Cervical numeric rating scale (NRS), cervical range of motion (ROM), neck disability index (NDI) and surface electromyography (SEMG) were measured before and after the treatment. Total NRS and the number of movement limitation of M-test were also measured before and after the treatment. Results Among the 36 participating subjects, 4 subjects were lost to follow-up or excluded in accordance with the criteria. Significant differences on Cervical NRS and NDI were found after the treatment (p<0.001). There was a significant difference in the range of left cervical rotation (p<0.05). Root mean square (RMS) of SEMG significantly decreased on the right sternocleidomastoid muscle (p<0.05), but significantly increased on the right trapezius muscle (p<0.05). Median frequency (MdF) of SEMG significantly increased on both sternocleidomastoid muscles. There appears to be significant differences after the treatment in total NRS and the number of movement limitation of M-test (p<0.05). Conclusions These results suggest that the evaluation and treatment of M-test based on the meridian and collateral theory were effective on cervical NRS and NDI, and also improved the movability of human body.

• The Journal of Korean Physical Therapy
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• v.15 no.3
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• pp.110-125
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• 2003

The purpose of this study investigated cervicocephalic kinesthetic sensibility in patients with chronic neck pain and the effect of a exercise treatment and transcutaneous electrical nerve stimulation. Fourteen patients with a chronic neck pain participated in this study. Subjects were divided into three groups, one group had undergone medicine, another medicine and TENS, the other medicine and TENS and exercise. the result of this research were as follow 1. No significant differences were found in medicine group and medicine and TENS during 4 weeks follow-up(P>.05). 2. Head reposition errors were significant in medicine and TENS and exercise during 4 weeks follow-up(P<.05). 3. In a period of treatment time, significant differences were found in each groups(P<.05).

• Journal of Acupuncture Research
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• v.28 no.2
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• pp.1-11
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• 2011

Objectives : The aim is to comprehend the difference of moxibustion used according to applied body parts (knee pain, neck pain, back pain) to oriental doctors running clinic in Seoul. Methods : A sampling of 288 oriental doctors running clinic in Seoul was done and the doctors were asked to fill out 20 questions by interviewing directly from Nov. 23. 2009 to Jan. 9. 2010. Results : The result shows that moxibustion was used for knee pain and back pain more than neck pain. The type of moxibustion mostly used was sticker moxibustion for all three symptoms. Burn marks were left mostly in knee and back pain. Most large volume of moxa was used to back pain. More than half of the oriental doctors used 1-3 acupoints for one procedure and on average 2-3 sessions was done. Patients with knee pain and back pain had more than 4 sessions compared to neck pain. Treatments were mostly done 3 times a week, and as for total treatment period, it took less than 1 week for acute symptom, and it took more than 1 week and less than 5 weeks for chronic symptom. Conclusions : This research shows that the method of moxibustion used differs according to the area of treatment(knee pain, neck pain, back pain) by survey of oriental doctors through direct interviews.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.105-108
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• 1998

Backgrounds: Cervical epidural nerve block is useful in the management of a variety of acute, chronic and cancer related pain syndromes involving the head, face, neck and upper extrimity. To safely perfom the cervical epidural block, an appreciation of the expected distance from skin to epidural space is important. We studied the distance from skin to cervical epidural space of adults to determine if any relationship exists between patient height, weight and neck circumference and the distance from skin to epidural space. Methods: Patients 170, suffering from neck and upper extremity pain with cervical HIVD(herniated intervertebral dics) were selected. Cervical epidural block was performed at $C_{6\sim7}$ or $C_{7-}T_1$ intervertebral space. Then measured the distance from skin to epidural space and analysed the relationship between age, height, weight and neck circumference and the distance from skin to epidural space. Results: The cervical epidural depth of male $C_{6\sim7}$, male $C_{7-}T_1$, female $C_{6\sim7}$ and female $C_{7-}T_1$ groups were $5.17{\pm}0.63$, $5.47{\pm}0.59$, $4.84{\pm}0.56$ and $5.01{\pm}0.60$ cm respectively. Cervical epidural depth significantly correlated with body weight, ponderal index and neck circumference. Conclusions: The distance from skin to cervical epidural space has significant relationships with weight, ponderal index and neck circumference. Although experience is important, patient's weight and neck circumference are indicating factor, of the cervical epidural depth.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.4
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• pp.289-294
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• 2022

Background: Orofacial pain is defined as pain felt in the soft or hard tissues of the head, face, mouth, and neck. Chronic orofacial pain is often challenging to diagnose and difficult to treat. Due to the lack of available information about the prevalence and clinical form of orofacial pain, this study aimed to evaluate the characteristics of chronic orofacial pain in patients presenting at the Department of Oral Medicine of Shahid Beheshti Dental School between 2012 and 2022. Methods: In this retrospective study, we evaluated the files of 121 patients at the Department of Oral and Maxillofacial Diseases of Shahid Beheshti Dental School, which were completed during 2012-2022. We extracted the required information from these files. Results: In total, 121 files were included in the study (30 male, 91 female). The mean age of the patients was 43.68 ± 16.79 years. The most common diagnosis in patients with chronic orofacial pain was temporomandibular disorders (TMD) (55.3%). Among pain-related factors, psychological factors showed the highest frequency (30.5%). Opening and closing (43.8%) had the highest frequency among factors that increased pain, and the rest (6.6%) had the highest frequency among the factors that reduced pain. Most patients experienced unilateral pain over the masseter area. Most patients reported their pain intensity to be greater than 7 in the verbal analog scale (VAS). The most common symptom associated with pain was joint noise (37.1%). Conclusion: A ten-year retrospective evaluation of patient files showed that more than half of the patients with chronic orofacial pain had TMD.

• Journal of Oral Medicine and Pain
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• v.35 no.3
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• pp.221-227
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• 2010

MyoFascial Pain Syndrome(MFPS) is defined as a regional pain syndrome characterized by muscle pain caused by myofascial trigger points (MTrPs). Myofascial pain is a common cause of persistent regional pain such as neck pain, shoulder pain, headaches, and orofacial pain. Clinicians who deal with orofacial pain must also understand the role of myofascial pain. This case report presents the treatment of botulinum toxin A for chronic myofascial pain.

• Physical Therapy Korea
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• v.28 no.1
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• pp.36-46
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• 2021

Background: It is reported that the proprioceptive sensation of patients with neck pain is reduced, and neck sensory-motor control training using visual feedback is reported to be effective. Objects: The purpose of this study is to investigate how sensorimotor control training for the cervical spine affects pain, function, and psychosocial status in patients with chronic cervical pain. Methods: The subjects consisted of 36 adults (male: 15, female: 21) who had experienced cervical spine pain for more than 6 weeks. An exercise program composed of cervical stabilization exercise (10 minutes), electrotherapy (10 minutes), manual therapy (10 minutes), and cervical sensorimotor control training (10 minutes) was implemented for both the experimental and the control groups. The cervical range of motion (CROM) and head repositioning accuracy were assessed using a CROM device. In the experimental group, the subjects wore a laser device on the head to provide visual feedback while following pictures in front of their eyes; whereas, in the control group, the subjects had the same training of following pictures without the laser device. Results: There were no statistically significant differences between the two groups in pain, dysfunction, range of motion, or psychosocial status; however, post-test results showed significant decreases after 2 weeks and 4 weeks compared to baseline (p < 0.01), and after 4 weeks compared to after 2 weeks (p < 0.01). The cervical joint position sense differed significantly between the two groups (p < 0.05). Conclusion: In this study, visual feedback enhanced proprioception in the cervical spine, resulting in improved cervical joint position sense. On the other hand, there were no significant effects on pain, dysfunction, range of motion, or psychosocial status.